Clinical stakeholders’ opinions on the use of selective decontamination of the digestive tract in critically ill patients in intensive care units: an international Delphi study

• DOI: 10.1186/cc13096
• Publication Date: 2013-11-08T12:01:23Z
• Authors: Brian H Cuthbertson; Marion K Campbell; Graeme MacLennan; Eilidh M Duncan; Andrea P Marshall; Elisabeth C Wells; Maria E Prior; Laura Todd; Louise Rose; Ian M Seppelt; Geoff Bellingan; Jill J Francis
• Keywords: Delphi Method; Digestive tract; Human decontamination

Abstract Introduction Selective decontamination of the digestive tract (SDD) is a prophylactic antibiotic regimen that not widely used in practice. We aimed to describe opinions key ‘stakeholders’ about validity existing evidence base, likely consequences implementation, relative importance their influencing overall practice, barriers implementation and perceptions requirement for further research inform decision whether embark on large randomised controlled trial. Methods This was Delphi study informed by comprehensive framework possible determinants health professionals’ behaviour Critical Care practice four countries. There were stakeholder participant groups including ICU physicians, pharmacists, clinical leads, microbiologists/ infectious disease physicians. Round one comprised interviews Rounds two three online questionnaires using method. Results In this study, 141 participants recruited whom 82% retained. Participants rated themselves as knowledgeable SDD. Antibiotic resistance identified most important issue. SDD seen low priority but few reported strong opposition. moderate agreement date has adequately addressed concerns lacks generalizability. indicated equipoise with regard benefits harms SDD, support Conclusions Clinicians have effectiveness Future requires longer follow up assess well greater validity/generalizability provide definitive answers effects resistance. regarded being high priority, which may limit future trial participation. These results critical care both warranted appropriate.